The Culture of Alcohol in the U.S. Military: Correlations With Problematic Drinking Behaviors and Negative Consequences of Alcohol Use

• Author: Sarah O. Meadows,Robin Beckman,Charles C. Engel,Diana D. Jeffery
• DOI: http://doi.org/10.1177/0095327X211069162
• Published date: 01 April 2023
• Date: 01 April 2023
• Subject Matter: Articles

https://doi.org/10.1177/0095327X211069162

Armed Forces & Society

2023, Vol. 49(2) 531 –555

© The Author(s) 2022

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DOI: 10.1177/0095327X211069162

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1134644AFSXXX10.1177/0095327X211069162Armed Forces & SocietyMeadows et al.

research-article2022

The Culture of Alcohol in the

U.S. Military: Correlations

With Problematic Drinking

Behaviors and Negative

Consequences of Alcohol Use

Sarah O. Meadows

1

, Robin Beckman

1

, Charles C. Engel

1

, and

Diana D. Jeffery

2

Abstract

Excessive alcohol use, especially binge and heavy drinking, represents a serious threat

to force readiness across the Department of Defense. Though these behaviors are a

matter of individual service member choice, they are inf‌luenced by perceptions of the

culture of alcohol use in the military. This paper uses data from the 2018 Health Related

Behaviors Survey of Active Duty service members to explore associations between

perceived alcohol culture and excessive alcohol use, any serious drinking conse-

quences, risky driving behaviors, productivity loss due to drinking, absenteeism, and

presenteeism. Results from multivariate logistic regression reveal a strong, positive

correlation between positive perceptions of drinking culture in the military and all

outcomes. Targeting perceptions of the drinking culture is one way the military can

reduce excessive and unhealthy use of alcohol and negative sequelae.

Keywords

military culture, alcohol, health behaviors, readiness

1

RAND Corporation, Santa Monica, CA, USA

2

Health Psychologist, Washington, DC, USA

Corresponding Author:

Sarah O. Meadows, RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA.

Email: smeadows@rand.org

532 Armed Forces & Society 49(2)

Levels of hazardous alcohol use behaviors among Active Component service members

are high, above that of civilians (Substance Abuse and Mental Health Services

Administration [SAMHSA], 2019) and above benchmarks set by the Off‌ice of Dis-

ease Prevention and Health Promotion (Healthy People 2030; U.S. Department of

Health and Human Services, 2021). Problematic alcohol use has been associated with a

number of negative mental, physical, and social health outcomes (Greenf‌ield et al.,

2015;Rehm et al., 2017;Taylor et al., 2010). For the military, alcohol use among

service members may have even more signif‌icant implications because any impairment

could negatively impact the readiness of the force.

Several factors play a role in determining an individual’s propensity to use and

misuse alcohol. These include individual-level demographic factors, such as age

(Vasilenkoet al., 2017) and gender (Wilsnack et al., 2018). However, factors outside the

individual are also relevant to patterns of alcohol use (e.g., amount and setting). For

example, some research has described a “culture of drinking”on college campuses

(Task Force of the National Advisory Council on Alcohol Abuse and Alcoholism,

2002). Given that rates of alcohol use among service members and college students are

similar (see Kreiger et al., 2018), it is possible that they may share a similar alcohol

culture. Exactly how this larger culture is associated with any given individual’s own

behavior, or consequences of those behaviors, has not been explored in the military

context.

Problematic Alcohol Use in the Military

Data from the 2018 Health Related Behaviors Survey indicate that both binge drinking

(i.e., at least f‌ive drinks on the same occasion at least once for men; at least four drinks

on the same occasion at least once for women) and heavy drinking (i.e., binge drinking

on at least 1 or 2 days a week in the past 30 days) are common. Among Active

Component service members, 34.0% reported at least one instance of binge drinking in

the past 30 days and 9.8% reported heavy drinking (Meadows et al., 2021). Binge

drinking among U.S. adults age 18 and above from the 2018 NSDUH is 26.5%

(SAMSHA, 2019). The rate of heavy drinking, though not directly comparable due to

slight differences in the response options between the two data sources, is also lower

among civilians, at 6.6% (SAMHSA, 2019).

1

However, at least one study found that

when compared to a civilian sample matched on gender, age, race/ethnicity, marital

status, educational attainment, parental status, and sexual orientation (when available),

rates of both binge and heavy drinking were actually lower in the military (Wong et al.,

2020). This suggests that the demographic characteristics of the military population

(i.e., majority male and young) drive some of the observed differences in the two

populations.

Further, the level of binge drinking in the military is above the goal set forward by

the Off‌ice of Disease Prevention and Health Promotion in the Healthy People

2030 objective of 25.4% or fewer adults engaging in binge drinking (U.S. Department

of Health and Human Services, 2021). Perhaps even more concerning, the percentage

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